Misuse of Medicines in the European Union: A Systematic Review of the Literature

Casati, Alicia; Sedefov, Roumen; Pfeiffer-Gerschel, Tim

doi:10.1159/000337028

Cited by 220 publications

(219 citation statements)

References 133 publications

Supporting

Mentioning

212

Contrasting

Unclassified

Order By: Relevance

“…Access to existing treatment systems is hampered by stigma and poor consideration of needs, with pathways and outcomes complicated by requirements for the co-existing management of physical pain (Dobbin & Tobin, 2008;Fishbain et al 2008;Reed et al 2011). There is a public health and regulatory imperative to develop proactive responses tackling public availability of codeine containing medicines, risk minimisation in consumer self-treatment for physical and emotional pain, need for enhanced patient awareness of habit forming use and its consequences, and continued health professional screening and pharmacovigilence (Casati et al 2012;Cooper, 2013b;Agnich et al 2013;Van Hout et al 2014).…”

Section: Resultsmentioning

confidence: 99%

“…However, there is a lack of consensus around a definition of misuse of pharmaceutical opioid narcotics (Barrett et al 2008;Casati et al 2012;Cooper, 2013a) with broad misuse of pharmaceutical definitions including incorrect but legitimate use for medical purposes; use outside of acceptable medical guidelines when self-medicating at higher doses and for longer than advised; use for reasons other than for the instructions on the label or the intended purpose; recreational use for intoxication purposes; and where risks and adverse consequences outweigh the benefits (Nielsen et al 2008;Casati et al 2012).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

‘Codeine is my companion’: misuse and dependence on codeine containing medicines in Ireland

Hout

Horan

Santlal³

et al. 2015

Ir. j. psychol. Med.

View full text Add to dashboard Cite

Objectives. Global concern around over the counter availability of codeine containing products and risk of misuse, dependence and related harms are evident. A phenomenological study of lived experiences of codeine misuse and dependence was undertaken in Ireland, following the Pharmaceutical Society of Ireland's 2010 guidelines for restricted supply of non-prescription codeine containing products.Methods. In-depth interviews were conducted with a purposive sample of adult codeine misusers and dependents (n = 21), both actively using, in treatment and in recovery. The narratives were analysed using the Empirical Phenomenological Psychological five-step method (Karlsson, 1995). A total of 10 themes with 82 categories were identified. Two concepts at a higher level of abstraction above the theme-level emerged during the final stage of analysis. The concepts identified were 'emotional pain and user self-legitimization of use' and 'entrapment into habit-forming and invisible dependent use'. These concepts were reported in different ways by a majority of participants.Results. Findings are presented under the following themes: (1) profile and product preferences; (2) awareness of habit forming use and harm; (3) negotiating pharmacy sales; (4) alternative sourcing routes; (5) the codeine feeling; (6) the daily routine; (7) acute and chronic side effects; (8) social isolation; (9) withdrawal and dependence and (10) help-seeking and treatment experiences.Conclusions. There is a public health and regulatory imperative to develop proactive responses tackling public availability of codeine containing medicines, risk minimisation in consumer self-treatment for pain, enhanced patient awareness of potential for habit forming use and its consequences and continued health professional pharmacovigilence.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

‘Codeine is my companion’: misuse and dependence on codeine containing medicines in Ireland

Hout

Horan

Santlal³

et al. 2015

Ir. j. psychol. Med.

View full text Add to dashboard Cite

show abstract

“…[6] In most cases, these relatives and friends had obtained their prescriptions from a single doctor. [6] Drivers of prescription opioid abuse have been shown to include increased availability of therapeutic opioids, [7][8][9][10] a history of illicit substance use and abuse or a substance use disorder [11] and comorbid mental health disorders. [12] Societal costs of abuse of prescription opioid analgesics in the USA were estimated to be $55.7 billion in 2007.…”

Section: Introductionmentioning

confidence: 99%

Routes of abuse of prescription opioid analgesics: a review and assessment of the potential impact of abuse-deterrent formulations

Gąsior

Bond

Malamut

2015

Postgraduate Medicine

View full text Add to dashboard Cite

Prescription opioid analgesics are an important treatment option for patients with chronic pain; however, misuse, abuse and diversion of these medications are a major global public health concern. Prescription opioid analgesics can be abused via intended and non-intended routes of administration, both intact or after manipulation of the original formulation to alter the drug-delivery characteristics. Available data indicate that ingestion (with or without manipulation of the prescribed formulation) is the most prevalent route of abuse, followed by inhalation (snorting, smoking and vaping) and injection. However, reported routes of abuse vary considerably between different formulations. A number of factors have been identified that appear to be associated with non-oral routes of abuse, including a longer duration of abuse, younger age, male sex and a rural or socially deprived location. The development of abuse-deterrent formulations of prescription opioid analgesics is an important step toward reducing abuse of these medications. Available abuse-deterrent formulations aim to hinder extraction of the active ingredient, prevent administration through alternative routes and/or make abuse of the manipulated product less attractive, less rewarding or even aversive. There are currently five opioid analgesics with a Food and Drug Administration abuse-deterrent label, and a number of other products are under review. A growing body of evidence suggests that introduction of abuse-deterrent opioid analgesics in the USA has been associated with decreased rates of abuse of these formulations. The availability of abuse-deterrent formulations therefore appears to represent an important step toward curbing the epidemic of abuse of prescription opioid analgesics, while ensuring the availability of effective pain medications for patients with legitimate medical need.

show abstract

“…Psychoactive drugs are widely used in the treatment of common medical conditions such as pain, anxiety and sleep disorders (World Health Organization (WHO), 2006), but are also associated with substance use disorders and drug diversion (Casati et al, 2012;Fischer and Rehm, 2007;Griffiths et al, 2014;United Nations (UN), 2014;WHO, 2006). Drug diversion involves the illegal and medically unintended or unauthorized use and/or distribution of prescription drugs (Centers for Medicare & Medicaid Services (CMS)CMMS, 2012).…”

Section: Introductionmentioning

confidence: 99%

Non-prescribed use of psychoactive prescription drugs among drug-impaired drivers in Sweden

Tjäderborn

Jönsson

Sandström

et al. 2016

Drug and Alcohol Dependence

View full text Add to dashboard Cite

Aims: To determine the prevalence of non-prescribed drug use among subjects suspected of drug-impaired driving with a confirmed intake of a psychoactive prescription drug, and to identify associated factors. Methods:Subjects investigated for drug-impaired driving in Sweden during 2006-2009 with a confirmed intake of diazepam, flunitrazepam, tramadol, zolpidem or zopiclone were identified using the Swedish Forensic Toxicology Database. Information on dispensed prescription drugs was retrieved from the Swedish Prescribed Drug Register. Non-prescribed use was defined as a confirmed use of a psychoactive prescription drug intake confirmed by toxicological analysis in a subject by whom it was not dispensed in the 12 months preceding the sampling. Prevalence proportions were calculated for each drug and logistic regression was used to identify associated factors. Results: In total, 2225 subjects were included. The median age (range) was 34 (15-80) years and 1864 (83.8%) subjects were male. Non-prescribed use was found in 1513 subjects (58.7%); for flunitrazepam 103 (76.3%), diazepam 1098 (74.1%), tramadol 192 (40.3%), zopiclone 60 (29.7%), and zolpidem 60 (21.2%) subjects, respectively. Younger age and multiple-substance use were associated with nonprescribed use, whereas ongoing treatment with other psychoactive drugs was negatively associated with nonprescribed use. Conclusions: Non-prescribed use of psychoactive prescription drugs was common in subjects suspected of drug-impaired driving and was more frequent for benzodiazepines and tramadol compared to zolpidem and zopiclone. The young and multi-substance users were more likely, whereas subjects with ongoing prescribed treatment with other psychoactive drugs were less likely, to use non-prescribed drugs.

show abstract

Misuse of Medicines in the European Union: A Systematic Review of the Literature

Cited by 220 publications

References 133 publications

‘Codeine is my companion’: misuse and dependence on codeine containing medicines in Ireland

‘Codeine is my companion’: misuse and dependence on codeine containing medicines in Ireland

Routes of abuse of prescription opioid analgesics: a review and assessment of the potential impact of abuse-deterrent formulations

Non-prescribed use of psychoactive prescription drugs among drug-impaired drivers in Sweden

Contact Info

Product

Resources

About